Disability Rights Arkansas

Perimeter Behavioral of Forrest City / Woodridge of Forrest City

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Location: Forrest City, AR

Population Served: Males ages 12-17 and a specialized sexual rehabilitative unit for males ages 12-17

# of residents per unit: Up to 21 Residents per room: 1-3 (SRU has 1 or 3, never 2) Capacity: 66

Contact with family (Calls and visit schedule): Calls 2x/week.

Restraint utilized? Yes Chemical Restraint utilized?  Yes Seclusion utilized? Yes 

Treatment Components:

Clinical Director - LPC-TA

Therapists: 3 full-time therapists (1 LCSW, 1 LPC, 1 LMSW); 2 part-time/contract therapists (1 LCSW ACSW, 1 LAC)

Treatment modalities offered: DBT, CBT, TF-CBT, Person-Centered, Narrative, Reality, Anger Replacement Therapy

# of individual therapy sessions/week: 1x/week

# of group therapy sessions led by a licensed mental health professional/week: 3x/week

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PRLU or OLTC

Maltreatment, Notice of Incident, Visit Compliance Report

Resident was found with a nicotine vape and a THC vape during routine checks. Resident alleged the nicotine vape was given to him by a staff member, and the marijuana vape was given to him by a peer who snuck it into the facility upon admission. Facility confiscated the vapes and interviewed/collected written statements from the resident, peer, and staff member involved. Camera footage shows staff going into all rooms for routine bedtime checks but no evidence of vape usage from staff or resident(s). Staff member was immediately placed on administrative leave 02/23/24 and a report was made to the AR Child Abuse Hotline (accepted for investigation).

Licensing Specialist: Eleanor White.

Licensing completed interviews and reviewed video. Review of video showed that staff provided the nicotine vape to the resident. Staff was terminated on 3/1/24. The agency is implementing a more robust search policy for their admissions process.

  • Facility cited 109.1: Unprofessional conduct in the practice of child welfare activities shall include without limitation: Engaging in behavior that could be viewed as sexual, dangerous, exploitative, or physically harmful to children.

The CACD case was closed as TRUE. Licensing complaint was founded.

PRLU or OLTC

Notice of Incident, Peer Altercation, Self-Harm

Resident complained to nurses of pain to his right hand. Pain was due to swelling from hitting on the desk. Ice pack and ibuprofen administered. Resident also complained of right great toe hurting. Pain due to kicking another resident in the face. Physician notified and ordered X-Ray at Forrest City Medical Center ER. X-Ray results are “No acute fracture or dislocation” to either hand or foot.

PRLU or OLTC

Medical, Notice of Incident

Resident complained to nurses of chest and back pain described as sharp pain. Nurses took vitals. Physician notified and ordered resident to be further evaluated at Forrest City Medical Center ER. Resident was transferred to Arkansas Children’s Hospital for further treatment. Resident was discharged on 02/22/24 with diagnosis of acute pancreatitis. Medication prescribed and current medication adjustments made.

PRLU or OLTC

Accidental Injury, Notice of Incident

Resident fell in the gym and complained of pain in right ankle. Nurses assessed and administered Ibuprofen 200 mg. Resident was transported to Forrest City Medical Center for x-ray. Findings are as follows: “No acute fracture or dislocation. The ankle mortise is intact. Soft tissues are grossly unremarkable.” Ice pack administered for swelling. Resident is currently on activity restriction.

Police Report

Medical

Officers dispatched to Perimeter to assist EMS with an unresponsive juvenile who was having a seizure. Juvenile was transported by EMS to Forrest City Medical Center.

PRLU or OLTC

Medical, Notice of Incident

Resident became unresponsive and displayed seizure like activity. Staff called a Code Blue, called 911, and the nurse initiated compressions. Upon EMS arrival, resident was conscious but non-verbal. Resident was transported to Forrest City Medical Center via ambulance. Several tests were conducted. While at FCMC, resident had a seizure and was transported to Le Bonheur Children’s Hospital. Resident is currently still at Le Bonheur Children’s Hospital at the time of this notification.

Resident was returned to the facility after receiving medical treatment for seizures. Youth has not had any further complications with seizures since returning.

PRLU or OLTC

Maltreatment, Notice of Incident, Visit Compliance Report

Resident alleged that a staff member pushed and pinched him the gym. Nurses assessment did find one bruise appearing fresh and purple and two other bruises appearing old and brown all in the same right upper bicep area. Nursing called allegations into AR Child Abuse Hotline and it was accepted. Upon review by Safety Team, no findings of abuse were cited. Statement gathered from staff around incident. No further injuries noted and resident denies pain. Resident stated that staff had pushed and pinched him in the gym bathroom for peeing on the floor and breaking the toilet seat.

Licensing Specialist: Eleanor White.

Licensing reviewed camera footage. Resident grabbed the staff clipboard which was recovered by staff. Resident then pulled down his pants. Staff redirected him to pull his pants back up. Footage did not show staff pushing or pinching. There are no cameras in the bathroom. Agency declares their housekeeping staff did not find urine on the floor or a broken toilet seat in the gym bathroom. No licensing violations.

The CACD case was unsubstantiated. Licensing complaint was unfounded. Staff member was approved to begin working again.

PRLU or OLTC

Medical, Notice of Incident

Resident was transported to Forrest City Medical Center for treatment of a UTI. Resident prescribed medication that has been reconciled into medication record. Youth has recovered after completing prescribed antibiotic treatment.

PRLU or OLTC

Improper ESI, Notice of Incident, Visit Compliance Report

Resident was transported to Forrest City Medical Center for further assessment/x-ray to his left wrist due to swelling. X-ray findings: No acute fracture or dislocation.

Licensing Specialist: Chelsea Vardell

On 05/07/24, licensing visited the facility in response to complaint case 020873 (see 04/18/24 Notice of Incident for reference). The resident had complained of wrist swelling due to an improper ESI that occurred on 02/11/24 and was not included in the report to licensing.

Citation issued (905.9): Staff did not use the minimal force necessary during the course of the restraint hold. Staff took the resident to the floor in a restraint hold and once on the floor, the staff can be seen aggressively moving the resident around the floor in an attempt to obtain another position, then lays on top of the resident visibly putting his body weight on the resident.

The staff member involved was already terminated due to another incident in which the staff member displayed unprofessional conduct (occurred after this restraint).

PRLU or OLTC

Notice of Incident, Peer Altercation

Resident was transported to Forrest City Medical Center for further assessment/x-ray to his right hand due to altercation with peer. Resident returned to facility with diagnosis of a fracture to right thumb. Resident received cast and was placed on activity restriction and on peer restriction from the resident whom he was in an altercation with.

PRLU or OLTC

Visit Compliance Report

Licensing Specialist: Eleanor White.

Census: 52. Licensing Specialist did a complete walkthrough of the facility. Viewed bedrooms, bath/shower rooms, recreation rooms in stations 1 and 2, nurse’s stations 1 and 2, kitchen, classrooms, seclusion rooms, gym, and recreational yard/area. No concerns noted.

Fire extinguishers, severe weather and fire drill logs, and vehicle inspection logs reviewed. MARs reviewed for 3 residents, no errors. No regulations out of compliance. No technical assistance needed.

PRLU or OLTC

Notice of Incident, Peer Altercation

Client was transported to Forrest City Medical Center for further assessment and X-ray to his left hand due to altercation with peer. X-ray results were negative for fracture or dislocation.

Police Report

Juvenile Runaway

Officers were dispatched to Perimeter Forrest City in reference to three runaway juveniles. Officers met with employee Jennings. Jennings stated the juveniles kicked the fence down outside and ran toward the Dillard St. area. The area was searched, and no contact was made with any of the three males.

All three residents were later found and returned to Perimeter unharmed.

PRLU or OLTC

Elopement, Notice of Incident

Three residents eloped from the gym. All residents returned to facility at 2055 (8:55 pm cst) by Forrest City Police Department. Residents have since been placed on elopement precautions.

Program Coordinator inquired about camera footage. Police report was requested from Forrest City Police Department.

PRLU or OLTC

Notice of Incident, Self-Harm

Resident was taken to Forrest City Medical Center due to right hand swelling. Resident stated that he “fell out of his chair on purpose and I know what I was doing.” Resident returned to facility from FCMC with the following findings: Right hand swelling. No acute fracture or dislocation.

PRLU or OLTC

Medical, Notice of Incident

Resident was taken to Forrest City Medical Center due to an elevated reading of potassium during his labs. Resident returned to facility the same day from FCMC with following diagnosis: Hyperkalemia, resolved Potassium 4.5.

PRLU or OLTC

Medical, Notice of Incident

Resident was taken to Nurses station after complaints of nausea and weakness. Resident also appeared pale. Resident was sent to Forrest City Medical Center ER for further evaluation. Resident returned to facility with following diagnosis: Viral Infection, unspecified.

PRLU or OLTC

Medical, Notice of Incident

Resident was transported to LeBonheur Children’s Hospital for further evaluation after complaints of dizziness, another episode of syncope, head trauma and nausea and vomiting. The resident returned from Lebonheur with a diagnosis of vasovagal syncope. The resident had a chest x-ray and EKG and found no abnormalities.

PRLU or OLTC

Maltreatment, Notice of Incident, Visit Compliance Report

Resident was taken to nurses station to share allegations of physical abuse by another staff. Nursing staff called the child abuse hotline and the allegation was accepted. A red bruise in the shape of a handprint was noted on the child’s back. Resident stated he was in his room and the accused staff came in, slammed the resident down, hit him in the back and kneed him in the head. Staff was placed on administrative leave pending the investigation outcome.

Licensing Specialist: Kendra Rice

Program Coordinator reviewed video and observed the staff member walk into the resident’s bedroom two times, but was unable to view what occurred inside the bedroom due to no camera coverage in private areas. Program Coordinator observed resident come out of his bedroom with a laundry basket and throw it at the staff member. Program Director reported that he contacted staff member to come to the facility, but staff member had not come to the facility or returned a phone call as of 1/31/2024. Staff member was terminated.

CACD investigation found unsubstantiated. Licensing complaint was unfounded.

PRLU or OLTC

Medical, Notice of Incident

Resident was taken to Forrest City Medical Center due to nausea and vomiting. The resident passed out due to dizziness but no evidence of concussion, head injury, or bodily injury. The ambulance was called and resident was transported to the ER for assessment. Resident returned same day. Resident was diagnosed with vomiting and prescribed ondansetron 4 mg (oral) as needed.

PRLU or OLTC

Medical, Notice of Incident

Resident reported to staff that he was feeling light headed and dizzy and he was taken to the nurses station for evaluation. Corrective Actions Taken: Nurse assessed resident. He was observed to have low blood pressure. After consult with the APRN, APRN ordered that he be sent to Forrest City Medical Center for medical examination and x-ray. Diagnosed with upper respiratory infection, unspecified. Was given Tylenol and sent back to the facility for continuance of care.

PRLU or OLTC

Maltreatment, Notice of Incident, Visit Compliance Report

Resident complained of pain and swelling to nose and mouth after ESI for physical aggression toward staff and attempted property destruction. Corrective Actions Taken: Resident was seen by APRN and sent to Forrest City Medical Center. After assessment and x-ray it was determined that there was a fracture to his nose but the age of the fracture was undetermined.

Licensing Specialist: Chelsea Vardell

Facility and Licensing staff reviewed nursing notes, camera footage, staff training, staff discipline reports, and staff regulatory checks. Nursing notes revealed resident sustained lacerations to inside of lip causing him to bleed during the restraint. The nursing note does not report any visible injury to the resident’s nose and facility records indicate that resident did not complain of pain to his nose until the following day.

The facility received Technical Assistance (TA) for 905.9: Video showed resident actively attempting to kick doors and hit an exit sign when a staff member used an incorrect maneuver to place the resident in a restraint hold. The staff who initiated the restraint received a written reprimand for the hold and was re-educated on proper techniques by SAMA instructor Cliff Williams.

Police Report

Disturbance

Caller advised that he needs to make a report on one of the residents.

PRLU or OLTC

Accidental Injury, Notice of Incident

Resident was sent to the ER after falling in the gym while playing and injuring 3rd digit. Corrective Actions Taken: Nurse assessed resident, and he was sent to Forrest City Medical Center for medical examination and x-ray after consultation with the APRN. Diagnosed with non-displaced hairline fracture of the epiphysis of the middle phalanx.